12 Friction Points Killing Conversions in Your Dental Practice

By Wes Lyon, CPA, CFP®

Speaking to thousands of dentists each year at study clubs, The Hinman Dental Meeting, our own seminars, and referring doctor events, one topic sticks out more than the rest; dentists perk up when I talk about the basics of white glove service. The first time I spoke about this was at our Disney seminar a few years back. One of our long-time attendees approached me and explained it was the best presentation I’ve ever given. As it turns out, we all need a wake up call sometimes. I grew up a military brat and have been to more dentists personally than most people have ever even seen. It’s staggering how many practices place ZERO effort into their conversions. I mean ZERO. Spending $3,000 per month on a marketing company, no problem! We see it all the time. But capturing the very people already convinced to see you isn’t a priority. Here are the 12 most common mistakes I’ve personally experienced as a patient that could cost you up to $100,000 or more each year:

1. The phone goes unanswered or to voicemail

A new patient calling your practice is shopping for a new dentist. Your marketing has worked and they’ve landed on your website and consciously dialed your practice. If your front desk is at lunch, between patients, or simply overwhelmed, that call goes to voicemail—and most prospective patients won’t leave one. They’ll call the next office on the list.

Pull your call logs. How many inbound calls go unanswered during business hours? How many of those are unique numbers that never call back? That’s your leak.

2. The first call feels transactional, not welcoming

There’s a meaningful difference between “Dental office, can I help you?” and a warm greeting that uses the practice name, the team member’s name, and an open-ended invitation. The first call sets the patient’s expectation for the entire relationship. If it feels like a DMV interaction, the patient assumes the rest of the experience will too, and they discount the value of any treatment recommendation accordingly.

Example Script for New Patient: I’m so thankful you have chosen us for your dental care, you’re going to love it here. Dr. Jane/John Doe is my favorite. If you have just a couple of minutes, I’ll grab a few pieces of information and go ahead and get you scheduled.

3. Insurance verification becomes the whole conversation

Many new patient calls get hijacked by insurance questions in the first ninety seconds, often times driven by the front desk employee! “Do you have dental insurance?” Or, the patient asks if you take their plan immediately. Showing excitement will help drive the conversation in the right direction, but won’t completely solve the problem. Make sure to ask the patient what prompted them to call today. I once called an office to hear, “What type of appointment would you like?” While I understood the context, “What prompted you to call today?” in a warm friendly voice is a much better way of gathering data. The next step is to start viewing insurance as a benefit to help make treatment affordable, even if you despise it or are out-of-network. Avoid the number one sin of the front desk and NEVER ask a patient if they have insurance. Instead, try, “Do you have any insurance benefits that we can file upon your behalf?” This avoids having to tell a patient you don’t take their insurance, which can often lead the patient to calling another office.

4. Scheduling friction at the moment of intent

If the next available new patient appointment is three weeks out, or if the only morning slots are six weeks away, you’ve created a window during which the patient’s motivation cools, life intervenes, and competing offices solicit them. When someone makes the decision to purchase a product or service, you need to make the sale immediately, not on your timeframe. Audit your schedule for new patient blocks and ensure you have slots blocked off for new patients regularly.

5. The pre-appointment communication is silent or robotic

Between scheduling and the appointment, the practice has an opportunity to build trust: a personalized welcome email, a short video introducing the doctor, clear directions and parking instructions, intake forms delivered digitally with enough lead time. Many practices send only a generic confirmation text. The patient arrives never having heard the doctor’s voice or seen a face. Instead, send personalized text messages and have the front desk leave a voicemail letting the patient know how excited they are to see them. This has the same impact as a confirmation call, but makes the experience better and avoids your office being confused with a hospital.

6. The waiting room signals the wrong things

Patients form impressions about clinical quality from non-clinical cues; we don’t know dentistry. Worn furniture, outdated magazines, a television tuned to cable news, dim lighting, a check-in counter that towers over them—all of these communicate something about how the practice is run. On the other end of the spectrum, I once walked into a dental office with pool tables in the waiting room. That should have been a hint to run from bad treatment. Stand in your own waiting room for ten minutes and look at it as a stranger would. What is it telling them about the care they’re about to receive?

7. The intake paperwork asks too much, too clinically

Long medical history forms presented on a clipboard, with no explanation of why the information matters, position the practice as bureaucratic. Worse, they miss a chance to ask the questions that actually drive case acceptance. What brought you in? What has your past dental experience been like? What would you change about your smile if you could? Those questions, asked sincerely, give the doctor and team the language they’ll need later when presenting treatment.

8. The hygienist and doctor don’t connect the dots

In many practices, the hygienist completes a thorough exam, takes images, and then hands off to the doctor with a brief clinical summary. The doctor walks in, performs their own exam, and presents findings, often without referencing what the patient told the hygienist about their concerns or goals. The patient feels unheard and the experience mimics a hospital. A simple handoff protocol where the hygienist briefs the doctor on the patient’s stated concerns, not just clinical findings, dramatically changes the tone of the doctor exam. Even better, the hygienist lets the patient know what the doctor is likely to tell them based on their experience, reinforcing any necessary treatment.

9. Findings are presented in clinical language patients can’t translate

“Number 14 has a defective MOD with recurrent decay and a vertical crack visible on transillumination, so we’re recommending a crown,” lands very differently than “This back tooth has an old filling that’s failing, and there’s a crack starting to run down into the root, if we don’t address it, you’re looking at a likely fracture and possibly losing the tooth.” Both statements can be accurate, but as a CPA, I only understand one.

10. Visual evidence is missing or underused

Patients accept treatment they can see. Every time I look at my intraoral camera photos I start begging for dentistry, although treatment is rarely needed. While my teeth look healthy to my dentist, every nook and cranny looks like a problem to me! Have the hygienist show the patient the photos ahead of time or put them on the screen before the doctor walks in. Last time I needed a filling I saw the photos before the doctor walked in. I had two questions, how bad is it and how quickly can we fix it? It ended up just being a small filling and the doctor was able to do it immediately. I was relieved to get my tooth fixed and gladly handed over my money afterwards.

11. The financial conversation is rushed or hidden

Treatment is presented enthusiastically by the doctor, then the patient is handed off to the front desk, where a number is delivered without context and a payment plan is mentioned almost apologetically. If the financial coordinator hasn’t been part of the trust-building, and if financing options haven’t been pre-positioned during the visit, the cost number lands as sticker shock rather than as the next logical step. Patients often say they need to “think about it” not because they doubt the dentistry, but because the financial conversation felt uncomfortable.

12. There’s no structured follow-up on unscheduled treatment

A patient who leaves without scheduling recommended treatment is not necessarily a lost case, but they will be if no one follows up. Most practices either don’t track unscheduled treatment at all or track it in a report that nobody actions. A simple weekly review of the unscheduled treatment list, with a designated team member making warm follow-up calls (not sales calls), recovers a meaningful percentage of cases that the practice had already invested in producing.

Take Away: Audit Your Practice!

Reading a list like this is useful, but only if you act on it! I suggest a few different quick ways to get started:

• Have someone outside the practice such as a friend, spouse, or a secret shopper call as a prospective new patient and document the experience minute by minute.
• Block some time off your calendar sporadically and actually spend time with the front desk to see it in action for yourself. Even better, pick up the phone or greet patients walking through the door. I find great value in periodically answering the phone here at McGill and Lyon.
• Pull your unscheduled treatment report and your new patient call log for the past 90 days. See if you can identify patterns.
• Pick the two or three friction points with the largest revenue impact and start fixing them. Assign ownership to different staff members and check back in after 30 days.

Want to stay up to date on all tax, practice, and financial strategies for dentists?

Want to hear more from our team on improving your patient experience? Register for one of our seminars!